Provider Demographics
NPI:1275251407
Name:HEIMDAL, JANEE DONALDSON (CMHC-I)
Entity Type:Individual
Prefix:
First Name:JANEE
Middle Name:DONALDSON
Last Name:HEIMDAL
Suffix:
Gender:F
Credentials:CMHC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1128 E 960 S APT 213
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84606-6352
Mailing Address - Country:US
Mailing Address - Phone:385-208-5631
Mailing Address - Fax:
Practice Address - Street 1:1433 N 1200 W
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-2449
Practice Address - Country:US
Practice Address - Phone:801-655-5450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health